Provider Demographics
NPI:1679531107
Name:KAUFFMAN, PATRICIA LITKE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LITKE
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MOORE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2525
Mailing Address - Country:US
Mailing Address - Phone:617-489-4888
Mailing Address - Fax:617-489-4889
Practice Address - Street 1:18 MOORE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2525
Practice Address - Country:US
Practice Address - Phone:617-489-4888
Practice Address - Fax:617-489-4889
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA420692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA42069OtherMASSACHUSETTS MEDICAL LIC
CAG048576OtherCA MEDICAL LICENSE
MA42069OtherMASSACHUSETTS MEDICAL LIC
MAKA A21752Medicare ID - Type Unspecified